Department for Transport

Heathrow Airport

Baroness Tonge: To ask Her Majesty’s Government what assessment they have made of how to achieve legally binding targets for air pollution should the third runway at Heathrow proceed.

Lord Ahmad of Wimbledon: The Airports Commission published a large amount of analysis on air quality, which included an assessment of potential impacts on limit values, in its Final Report, which is available in the libraries of the House. In addition, as announced in December, we are testing the Airports Commission’s work on air quality against the Government’s new air quality plan, as recommended by the Environmental Audit Committee.

Department for Business, Innovation and Skills

Business: Staff

Baroness Mobarik: To ask Her Majesty’s Government how many employees (1) small and medium-sized businesses, and (2) companies employing more than 250 people, have in total in the UK.

Baroness Neville-Rolfe: The 2015 Business Population Estimates show that employment in small and medium-sized businesses in the UK was 15.6 million, whilst employment in large businesses was 10.3 million. Small and medium-sized businesses are those with 0-249 employees and large businesses are those with 250 or more.

Sunday Trading

Baroness Mobarik: To ask Her Majesty’s Government what estimate they have made of how relaxing Sunday trading laws in England and Wales would affect the UK economy annually in terms of (1) full-time equivalent jobs, (2) GDP, (3) extra tax revenue in terms of (a) VAT, (b) Corporation Tax, (c) National Insurance, and (d) other taxes, (4) revenue from overseas tourists, and (5) the net effect on balance of trade.

Baroness Neville-Rolfe: On 9 March the Government published an impact assessment on Sunday trading which is available in the libraries of both Houses. In view of the will of the House of Commons, we are no longer proposing to give local authorities the ability to extend the Sunday trading hours of large shops.

Zero Hours Contracts

Baroness Quin: To ask Her Majesty’s Government what is their assessment of the proportion of people on zero-hours contracts who are seeking full-time employment with guaranteed pay and hours of work.

Baroness Neville-Rolfe: The Government has not made an assessment. ONS statistics published on 9 March 2016, for the fourth quarter of 2015, show that for those individuals on a zero hours contract in their main job, 63 per cent were not looking for more hours or a different job.

Department for International Development

Global Fund to Fight AIDS, Tuberculosis and Malaria

Baroness Barker: To ask Her Majesty’s Government what was their bilateral spending on technical assistance to programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in the financial years from 2010–11 to 2014–15 in addition to their commitment of up to £1 billion for the Global Fund.

Baroness Barker: To ask Her Majesty’s Government what is their expected bilateral spending on technical assistance to programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in addition to their commitment to the Global Fund in (1) 2015–16, and (2) 2016–17.

Baroness Barker: To ask Her Majesty’s Government which organisations have received, or will receive, bilateral funding for technical assistance for programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria in (1) 2014–15, (2) 2015–16, and (3) 2016–17.

Baroness Verma: The Global Fund to Fight AIDS, Tuberculosis and Malaria is a critically important part of the international architecture for fighting the three diseases. The UK provides technical assistance to programmes funded by the Global Fund through the following organisations: the Stop-TB Partnership, Roll Back Malaria, UNAIDS and the World Health Organisation’s Global Malaria Programme. The table (below) shows DFID’s spend to these organisations over the last five financial years.(£ Millions) 2010/112011/122012/132013/142014/15WHOs Global Malaria Programme-1.503.501.503.50Roll Back Malaria0.521.001.630.631.23Stop TB Partnership1.001.901.500.501.00UNAIDS10.0010.0015.0015.0015.00  Total (£ Millions)11.5214.4021.6317.6320.73The UK is committed to remaining a world leader in tackling global diseases and ending the epidemics of AIDS, Tuberculosis and Malaria by 2030. Our future contributions to the Global Fund will be determined following the completion of the Bilateral and Multilateral Aid Reviews.

Department for Work and Pensions

Social Security Benefits: Disability

Lord Taylor of Warwick: To ask Her Majesty’s Government why they propose to cut £4.4 billion from benefits for disabled people over the course of the Parliament.

Lord Freud: We spend around £50bn every year on benefits alone to support people with disabilities or health conditions, with spending on Personal Independence Payment (PIP) and Disability Living Allowance (DLA) having increased by more than £3 billion since 2010. The government has no further plans to make welfare savings, beyond those already announced. The government is committed to talking to disabled people, their representatives, healthcare professionals and employers to ensure the welfare system works better with the health and social care systems and provides help and support to those who need it most.

Department for Environment, Food and Rural Affairs

Recycling

Baroness Jones of Whitchurch: To ask Her Majesty’s Government what assessment they have made of the effectiveness of co-mingled recycling collection in the light of the recycling target of 50 per cent of municipal waste by 2020.

Lord Gardiner of Kimble: Local authorities are best placed to determine local collection arrangements. From January 2015, under the Waste (England and Wales) (amendment) Regulations 2012, waste collection authorities were required to collect separately paper, plastic, glass and metals unless it is not necessary in order to provide high quality recyclates or its not technologically, environmentally or economically practicable to do so.As part of a wider study by WRAP to assess the factors influencing the recycling performance of local authorities it was concluded that very little certainty could be applied in establishing a difference in recycling performance between dry scheme types where schemes were collecting the same set of dry recyclable materials. This analysis considered data reported by local authorities for the year 2012/13 and the report is available on WRAP's website.With input from WRAP, Defra has considered a number of options for achieving higher recycling rates and this work has assumed a range of collection approaches as reflected by current practice. The work being taken forward to identify opportunities for greater consistency in recycling collections provides a further opportunity to consider the effectiveness of collection options in terms of contribution to national recycling rate, quality of material collected and cost effectiveness. This work will be reported on later this year.

Domestic Waste

Baroness Jones of Whitchurch: To ask Her Majesty’s Government what steps they are taking to review and propose simplification of household waste and recycling collection across the UK.

Lord Gardiner of Kimble: Defra and the Waste and Resource Action Programme are working with local authorities and other waste management stakeholders to develop a vision and business case for greater consistency in the way materials are collected for recycling. This will set out the benefits that could be achieved for householders, local authorities, reprocessors and others. The vision is to be published in the summer and will include proposed models for more consistent arrangements for collection of recyclable materials.The broad aims for this work are to help local authorities to reduce costs; improve the quality and quantity of materials collected and to improve householder engagement and participation in recycling through reducing confusion and inconsistency and providing opportunities to improve communications.

Tree Planting

Baroness Jones of Whitchurch: To ask Her Majesty’s Government what progress they are making in implementing their manifesto commitment to plant 11 million trees, and how such progress will be monitored and reported.

Lord Gardiner of Kimble: Between the beginning of April and the end of December 2015, around 495,000 trees were planted in newly created woodlands across the country, assisted by funding from the Rural Development Programme in England. Further planting figures for January to March 2016 are due to be published on 26 April. The area of woodland planted is published as one of Forestry Commission England’s headline indicators and is updated four times a year. Tree numbers are monitored through Countryside Stewardship administrative records and made available to the Programme Monitoring Committee of the Rural Development Programme.

Beverage Containers: Recycling

Baroness Jones of Whitchurch: To ask Her Majesty’s Government what steps they are taking to encourage coffee chains to recycle paper coffee cups.

Lord Gardiner of Kimble: Paper coffee cups are captured under the Packaging Waste Regulations. The UK meets its packaging waste recovery and recycling targets through a market-based approach. Packaging producers who put more than 50 tonnes a year of packaging materials on the market, and have an annual turnover of more than £2 million, are required to recover and recycle a proportion of their packaging waste. As a result most major coffee chains pick up a financial obligation to recycle their packaging waste, including paper coffee cups, through this mechanism. Defra is also working with campaigners and industry to develop a National Litter Strategy for England. In addition, we are aware of many major chains who are taking their own action to incentivise environmentally friendly behaviour, for example by offering a discount on drinks if customers bring their own reusable cups.

Food: Labelling

Baroness Jones of Whitchurch: To ask Her Majesty’s Government what further measures are planned for the labelling of meat and dairy products to recognise the high standards of welfare in British products.

Lord Gardiner of Kimble: Consumers buying meat and dairy products produced in the UK can be reassured that we have some of the highest animal welfare standards in the European Union. We pressed for new EU legislation extending country of origin rules from beef to fresh and frozen sheep, goat, pig and poultry meat to help consumers identify food produced in the UK. These came into force in April 2015. We are also pressing for this rule to be extended to dairy products. To support consumers further in making an informed choice, Defra is pressing the EU to implement rules to require that where food products indicate that they are produced in a specific country they must also state if the main ingredients are from a different country. 2016 is the Year of Great British Food. Through the Great British Food campaign Defra is working in partnership with industry to champion the outstanding quality of UK produce to help fuel demand for Great British Food.

*No heading*

Lord Jones of Cheltenham: To ask Her Majesty’s Government what assessment they have made of the review from Keele University, published in the Journal of Ecology, warning that almost all ash trees in Europe will be wiped out due to the fungal disease ash dieback and the emerald ash borer beetle, and what plans they have to tackle these twin problems.

Lord Gardiner of Kimble: We are committed to protecting our country from tree pests and diseases and we want to ensure that the ash tree continues to have a place in our environment. To support this we have invested over £21 million in tree health research. Natural tolerance to ash dieback does exist and the UK is leading research to identify resistant strains. Ash trees have a wide genetic diversity and potential for greater levels of resistance compared to other tree species affected by diseases. There have been no findings of emerald ash borer anywhere in the EU. We have identified this pest as a threat, have introduced restrictions to protect against its introduction and are screening native populations of ash trees grown abroad for resistance.

Department for Communities and Local Government

Devolution: South West

Lord Berkeley: To ask Her Majesty’s Government why their devolution agreement with Bath and North East Somerset Council, Bristol City Council, North Somerset Council, South Gloucestershire Council and the West of England Local Enterprise Partnership is called the West of England devolution agreement, in the light of the fact that it does not include Cornwall Council or Devon County Council.

Baroness Williams of Trafford: The West of England is the recognised name used to describe the area covered by the four local authorities: Bristol, North Somerset, South Gloucestershire and Bath and North East Somerset. The West of England is used to describe organisations and functions that work across this geography, which include the West of England Local Enterprise Partnership and the West of England Nature Partnership. Cornwall is already covered by a devolution deal – it is called the Cornwall Devolution Deal.

Council Housing: Finance

Lord Kennedy of Southwark: To ask Her Majesty’s Government what is the difference between a local authority being able to recover (1) its expenses, and (2) its reasonable costs, in matters relating to its duties around housing legislation.

Baroness Williams of Trafford: Local housing authorities incur a range of costs when carrying out their statutory homelessness duties. They have powers to require households to pay reasonable costs towards both the accommodation that it secures for them and property storage costs, however they cannot require households to pay actual costs where these are more than those determined to be reasonable. Authorities determine what constitutes a reasonable cost by taking account of a household’s personal circumstances, its finances and the nature of the accommodation.

Housing: Planning Permission

Lord Kennedy of Southwark: To ask Her Majesty’s Government what is their estimate of the number of approved planning applications for housing that have yet to be built.

Baroness Williams of Trafford: As at 1 March 2016, data provided to the department by Glenigan indicate that there were full planning permissions for 658,000 homes in England on sites on which work had either not yet started or completed. Of these around 55,000 (8 per cent) were on unstarted sites granted permission more than three years ago. Typically permissions for these homes will have expired.

Travellers: Discrimination

Baroness Whitaker: To ask Her Majesty’s Government what assessment they have made of the account in the Equalities and Human Rights Commission's report Is England Fairer? of the discrimination faced by Gypsies, Travellers and Roma, and how they propose to address this.

Baroness Williams of Trafford: The Government is committed to creating a fair society in which all people, of whatever ethnic origin or background, are able to participate fully in society and realise their full potential. The Government deplores racism in all its forms and is determined to ensure everyone has the opportunity to get on in life, free from harassment and fear.The UK has a strong and well-established legal framework to combat discrimination and hate crime, which protects all individuals, including Gypsies, Travellers and Roma, from racial and other forms of discrimination, and racially motivated crime.The Government is taking action to improve the situation of disadvantaged people, including Gypsies, Travellers and Roma, in a number of the areas of concern identified in the Equality and Human Rights Commission report. These include improving educational attainment and attendance; tackling bullying; improving access to healthcare; supporting people into work and keeping them there; tackling hate crime; and addressing the over-representation of ethnic minorities in the criminal justice system.

Community Engagement Forum

Lord Greaves: To ask Her Majesty’s Government, further to the Written Answer by Baroness Williams of Trafford on 15 March (HL6737) about the Community Engagement Forum, why they were unable or unwilling to provide a definition of the word "community".

Baroness Williams of Trafford: The Oxford English Dictionary defines community as 'a body of people who live in the same place, usually sharing a common cultural or ethnic identity'.

Affordable Housing: Construction

Lord Horam: To ask Her Majesty’s Government how many homes were completed under the Affordable Homes Programme launched in April 2011.

Baroness Williams of Trafford: The Government has delivered 193,000 affordable homes through the 2011-15 Affordable Homes Programme. This programme exceeded expectations delivering 23,000 more affordable homes than anticipated.

HM Treasury

Premium Bonds

Baroness Byford: To ask Her Majesty’s Government why National Savings and Investments stopped the sale of Premium Bonds for cash in Post Offices and withdrew their brochures, forms and reply envelopes at the same time, and what assessment they have made of the effect of that decision on the sale of Premium Bonds.

Lord O'Neill of Gatley: National Savings and Investments’ (NS&I) core remit is to provide cost effective financing for the Government. Over the past few years, NS&I has been moving its business to direct only channels – internet, phone and post – producing significant savings for the taxpayer. The end of Premium Bond sales and wider NS&I services at the Post Office was a commercial decision made by NS&I. This decision reflects the way that their customers are choosing to do business with NS&I and also the growth of the Post Office’s own range of savings products. The change followed the success of 65+ Pensioner Bonds, which saw over one million pensioners from around the country invest via direct only channels.

Sugar: Taxation

Lord Kennedy of Southwark: To ask Her Majesty’s Government what assessment they have made of the comments of Chief Executive NHS England, in response to the sugar tax announcement in the budget, that "sadly soft drinks are now our children’s largest single source of diabetes-inducing teeth-rotting excess sugar."

Lord O'Neill of Gatley: The evidence behind the comments from Simon Stevens, Chief Executive NHS England, comes from the Public Health England report ‘Sugar reduction: the evidence for action’ published in October 2015.  The PHE report states that soft drinks are the largest single source of sugar for children and teenagers in England, and that consuming too much sugar can lead to weight gain, which in turn increases the risk of heart disease, type 2 diabetes, stroke and some cancers. It is also linked to tooth decay. This is why at Budget 2016, the Chancellor announced a new levy aimed at the producers and importers of added sugar soft drinks. The levy is designed to encourage companies to reduce the amount of added sugar in soft drinks and move consumers towards healthier choices. The levy will from part of a wider comprehensive childhood obesity strategy which the government launch in the summer.

Cabinet Office

National Flood Resilience Review

Baroness Jones of Whitchurch: To ask Her Majesty’s Government how many meetings of the National Flood Resilience Review have taken place, and when that review is expected to report.

Lord Bridges of Headley: To protect the integrity of the policy making process, we do not comment on specific frequency or timings of ministerial meetings. The Review is set to be published this summer.

Department of Health

Hepatitis

Lord Hunt of Kings Heath: To ask Her Majesty’s Government what priority they give to the elimination of hepatitis C as a threat to public health.

Lord Hunt of Kings Heath: To ask Her Majesty’s Government what new steps they are taking to improve identification and testing of people potentially infected with hepatitis C as part of a coherent approach to treatment of the population at large.

Lord Prior of Brampton: The United Kingdom Government takes the issue of prevention, diagnosis and treatment of hepatitis C very seriously. Public Health England (PHE) and NHS England continue working together with key stakeholders to establish a strategic approach to tackle hepatitis C, including monitoring treatment access and uptake, as well as establishing Operation Delivery Networks (ODNs).NHS England has invested in a Commissioning for Quality and Innovation scheme to incentivise ODNs to meet their agreed rate of roll-out. If their treatment rates deviate from this agreed rate of treatment, they are no longer eligible for these incentives.PHE is working together with NHS England and the National Offender Management Service to improve coverage of blood borne virus testing for people in prisons through implementation of opt-out testing.PHE has also commissioned the Royal College of General Practitioners (RCGP) Certificate in the Detection, Diagnosis and Management of Hepatitis B and C in Primary Care to help raise awareness in primary care and among other professionals working with groups at high risk of chronic viral hepatitis infection. To supplement this, a new RCGP course was launched in April 2015, Hepatitis C: Enhancing Prevention, Testing and Care which comprises four lessons: understanding hepatitis C; preventing transmission; testing and diagnosis; and treatment and care.

Campylobacter

Baroness Jones of Whitchurch: To ask Her Majesty’s Government whether the Food Standards Agency achieved its target of halving the incidence of campylobacter food poisoning in 2015.

Lord Prior of Brampton: Although progress continues to be made, the Food Standards Agency’s (FSA) agreed target with industry to reduce the numbers of the most contaminated birds at the end of slaughter to less than 10% by 2015 was not met. However, given the interventions expected to come on stream within industry, the FSA Board agreed to roll the target to 2016, when it is expected that the target will be met. If the target is met, then a decrease of around 50% in the number of human cases of campylobacteriosis would be expected.

Campylobacter

Baroness Jones of Whitchurch: To ask Her Majesty’s Government whether they intend to take further steps to raise public awareness of the incidence of campylobacter in chickens.

Lord Prior of Brampton: The Food Standards Agency will continue to use social and news media opportunities to raise awareness of campylobacter and let people know how they can reduce the risk from campylobacter in their home. The Agency leads the Acting on Campylobacter Together campaign under which the poultry industry seeks to reduce the levels of the bacteria on the chickens they sell.

HIV Infection

Baroness Masham of Ilton: To ask Her Majesty’s Government what assessment they have made of the ability of people living with HIV to experience continuity of HIV care across the numerous health services and providers that they access.

Baroness Masham of Ilton: To ask Her Majesty’s Government what plans they have to increase awareness of co-morbidities associated with living with HIV in the long term.

Baroness Masham of Ilton: To ask Her Majesty’s Government, in the light of the ageing HIV population, what plans are being put in place to support the preservation of long-term health in people with HIV.

Baroness Masham of Ilton: To ask Her Majesty’s Government what assessment they have made of the opportunities presented by NHS England’s Five Year Forward View to improve HIV services.

Lord Prior of Brampton: The National Health Service continues to offer world class Human Immunodeficiency Virus (HIV) treatment services. In its role as the commissioner of specialised HIV care and treatment, NHS England has a service specification which emphasises the responsibility of commissioned providers to collaborate with other health, social care and third sector organisations as appropriate to help ensure the holistic needs of patients are met. This includes ensuring people living with HIV and other comorbidities have access and referral to appropriate services. The effectiveness of HIV treatment means that more people will live well with HIV in old age. As people living with HIV get older, they will require access to services for the other conditions they may experience. Good communication with their HIV provider is important and this is required in the service specification. In line with the Five Year Forward View, NHS England will continue to work closely with HIV organisations in order to inform its commissioning responsibilities with regard to specialised HIV care and treatment as well as ensuring primary and secondary health care services respond to the wider health needs of people living with HIV.  The Government’s Improvement Framework for Sexual Health includes the ambition that “older people with diagnosed HIV can access the additional health and social care services they need”. A copy is attached.  



Framework for Sexual Health Improvement in England
(PDF Document, 1020.3 KB)

Down's Syndrome

Lord Shinkwin: To ask Her Majesty’s Government what assessment they have made of the impact that the UK National Screening Council’s review of cell-free DNA testing has had, and will have, on the community of people with Down’s syndrome; and in particular, the impact of "cost per trisomy detected" being listed as an important factor to consider in their economic analysis.

Lord Prior of Brampton: There is a long established NHS Fetal Anomaly Screening Programme (NHS FASP) that prospective parents can choose whether to participate in. The UK National Screening Committee (UK NSC) recommendation on non-invasive prenatal testing (NIPT) does not change the choices available to prospective parents within the programme therefore no assessment has been made. The UK NSC announced its recommendation that NIPT should be introduced as an additional test into NHS FASP as part of an evaluation. The recommendation was not based on cost per trisomy but on the basis that NIPT is much more accurate than the current testing used in screening and can substantially reduce the number of pregnant women going on to have an invasive test, which itself carries a risk of miscarriage. The economic model reviewed by the UK NSC suggested that NIPT initially offered to women with a chance of greater than 1 in 150 of carrying a fetus with a trisomy would result in 9,912 NIPT tests being carried out, and 350 retests would be required. As a result of the NIPT testing, the number of invasive tests would fall from 7,910 to 1,434. The majority of invasive tests avoided are in trisomy free pregnancies, so that the number of test related miscarriage of healthy pregnancies would subsequently fall from 46 to three per year.

Parliamentary and Health Service Ombudsman

Lord Hunt of Kings Heath: To ask Her Majesty’s Government what assessment they have made of the leadership of the Parliamentary and Health Service Ombudsman.

Lord Prior of Brampton: The Government has expressed its concern on behalf of patients about some of the things that have been happening. It is important that patients have confidence in the Parliamentary and Health Service Ombudsman, but the Ombudsman is independent of Government, accountable directly to Parliament. This is therefore a matter for the relevant Select Committee of the House of Commons.

Strategic Projects Team

Lord Hunt of Kings Heath: To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 21 March (HL7013), why the NHS Strategic Projects Team was said to have employees in view of it not being an organisation and therefore not able to employ staff.

Lord Prior of Brampton: The Strategic Projects Team is hosted by Arden GEM Commissioning Support Unit. The staff referred to in HL7013 were on secondment from the CSU and NHS England and were therefore employees.

Royal Wolverhampton Hospitals NHS Trust

Lord Hunt of Kings Heath: To ask Her Majesty’s Government when the NHS Trust Development Authority will publish the findings of the review of whistle blowing and governance at the Royal Wolverhampton NHS Trust.

Lord Hunt of Kings Heath: To ask Her Majesty’s Government whether the timetable for publishing the review of whistle blowing and governance at the Royal Wolverhampton NHS Trust is linked to the role the trust is to play in the provision of services to patients in Staffordshire.

Lord Prior of Brampton: This is a matter for the NHS Trust Development Authority (TDA). We understand that the NHS TDA commissioned Verita to conduct an independent review of the procedures carried out by Royal Wolverhampton NHS Trust in investigating recent whistleblowing and human resource concerns. The NHS TDA has confirmed its commitment to publication of its report of the review. The NHS TDA is currently clarifying publication arrangements in the light of legal advice and in liaison with the Department. A publication date will be arranged as soon as possible. The NHS TDA has confirmed that the timetable for publication of the Verita report is independent of any issues relating to the Trust’s role in providing services to patients in Staffordshire.

Ophthalmology: Waiting Lists

Lord Hunt of Kings Heath: To ask Her Majesty’s Government how many patients are waiting, and for how long, for appointments in hospital with ophthalmic specialists.

Lord Hunt of Kings Heath: To ask Her Majesty’s Government how many patients are waiting, and for how long, for follow-up appointments in hospital with ophthalmic specialists.

Lord Prior of Brampton: The information is not available in the format requested. The referral to treatment waiting times standard is that 92% of patients still waiting to start consultant-led treatment for non-urgent conditions at the end of each month should have been waiting within 18 weeks from referral. At the end of January 2016, there were 327,066 patients waiting to start ophthalmology treatment, 94% of whom had been waiting within 18 weeks, with an average median waiting time of 6.9 weeks. It is not known how many of these patients were waiting for a first outpatient appointment rather than to be admitted to hospital. Information on how many patients are waiting for follow-up appointments, and for how long, is not collected.

Anaemia

Baroness Masham of Ilton: To ask Her Majesty’s Government what steps they are taking to increase diagnosis and treatment rates of iron deficiency anaemia.

Baroness Masham of Ilton: To ask Her Majesty’s Government what action they are taking following the British Society of Gastroenterology's observation that the management of iron deficiency anaemia is "often suboptimal, with most patients being incompletely investigated or not investigated at all".

Lord Prior of Brampton: It is for local National Health Service organisations to develop their own policy to treat patients with iron deficiency anaemia based on their clinical needs. The National Institute for Health and Care Excellence has produced a large body of guidelines aimed at professionals treating patients with anaemia who have chronic conditions, such as kidney disease and cancer. A copy of Chronic kidney disease: managing anaemia is attached. 



NICE Chronic Kidney Disease managing anaemia
(PDF Document, 202.66 KB)

Anaemia

Baroness Masham of Ilton: To ask Her Majesty’s Government what plans they have to introduce a Clinical Commissioning Group Outcome Indicator to address the growing number of hospital admissions attributable to iron deficiency anaemia.

Lord Prior of Brampton: The National Institute for Health and Care Excellence and the Health and Social Care Information Centre make recommendations to NHS England for new indicators for the Clinical Commissioning Group (CCG) Outcomes Indicator set. This process includes a public consultation on potential new indicators and at this stage an indicator on hospital admissions attributable to iron deficiency anaemia could be considered. Any new indicators that are selected by NHS England would be published in the 2016/17 CCG Outcomes Indicator Set during 2016, for commissioners to use them in 2016/17.

HIV Infection: Drugs

Lord Scriven: To ask Her Majesty’s Government what assessment they have made of the decision by NHS England not to provide Truvada on prescription as a pre-exposure prophylaxis in the treatment and prevention of HIV.

Lord Prior of Brampton: NHS England does not now consider pre-exposure prophylaxis (PrEP) for Human Immunodeficiency Virus (HIV) is suitable for prioritisation of specialised commissioning spend as it is a preventative measure. However given the potential benefits in this area, NHS England is keen to build on the work to date and will be making available up to £2 million over the next two years to run a number of early implementer test sites. These will be undertaken in conjunction with Public Health England and will seek to answer the remaining questions around how PrEP could be commissioned in the most cost effective and integrated way to reduce HIV and sexually transmitted infections in those at highest risk.

Radiotherapy

Lord Marlesford: To ask Her Majesty’s Government what NHS facilities are available for proton beam treatment for cancer in the UK; where the facilities are located; and when each became operational.

Lord Prior of Brampton: In 2012, the Government provided £250 million to build two high energy proton beam therapy (PBT) facilities at The Christie NHS Foundation Trust in Manchester and University College London Hospitals (UCLH) NHS Foundation Trust in London. Work has already started and is proceeding as quickly and safely as possible, with the first facility due to become operational in 2018. NHS England is committed to continuing the Proton Beam Therapy Overseas Programme until the centres being built at The Christie and UCLH are in a position to undertake the treatment currently being commissioned from overseas providers.

Health Services: Foreign Nationals

Lord Marlesford: To ask Her Majesty’s Government how much has been collected for treatment of foreign nationals by the NHS in each of the last three years; and how much has been paid to EU governments for medical treatment of UK citizens during the same period.

Lord Marlesford: To ask Her Majesty’s Government what progress they are making in introducing the requirement for non-UK citizens newly registered with general practitioners under the NHS general practice to inform hospitals to which they may be referred of the need to recover the cost of that treatment.

Lord Prior of Brampton: It is not possible to provide data on the amounts collected for treatment of directly chargeable foreign nationals and residents of countries outside the European Economic Area (EEA) by the National Health Service prior to financial year 2013-14. Since then the Department has been collecting data from NHS trusts on the amount of cash payments received in-year relating to invoices raised in current and previous years.   Figures for financial years 2013-14 and 2014-15 are shown in the table below.  Cash payments received in-year (relating to invoices raised in current and previous years) 2013-14Cash payments received in-year (relating to invoices raised in current and previous years) 2014-15 £millions£millionsNHS Trusts8.511.4NHS Foundation Trusts11.113.7Total19.625.1 Source:NHS Trust data – NHS Trust Development Authority NHS Foundation Trust Data – Monitor Since 6 April 2015 , temporary , non-EEA migrants coming to the United Kingdom for more than 6 months, or who apply to extend their stay in the UK, are required to pay the Immigration Health Surcharge (IHS) (unless an exemption applies) . In cash terms between 6 April 2015 and 14 March 2016, the Home Office collected IHS income, net of refunds and transferred £117.8 million to the Department for spending on the NHS. EEA countries and Switzerland reimburse the UK for the cost of the NHS providing treatment to people they are responsible for under EU law, including UK nationals insured in another EEA country or Switzerland. This information is available for the last three financial years in the attached table. The Department on behalf of the UK Government reimburses other EEA countries and Switzerland for the cost of providing treatment to people we are responsible for under European Union law, irrespective of nationality. This information is available for the last three financial years in the attached table. General practitioners (GPs) have discretion to register anyone as an NHS patient, including a person not ordinarily resident in the UK, for primary medical care free at the point of delivery. Being registered with a GP does not in itself mean that the person is entitled to free NHS hospital treatment. Practices are strongly encouraged to provide NHS providers with any relevant information when they refer a patient they believe may be chargeable for secondary care.



Table 1 UK Claims
(Word Document, 23.82 KB)




Table 2 MS Claims
(Word Document, 23.9 KB)

*No heading*

Baroness Gale: To ask Her Majesty’s Government what assessment they have made of the impact on the NHS of NHS England cutting the role of National Clinical Director for Adult Neurology, and the end of national funding for neurological work by clinical networks.

Lord Prior of Brampton: Sir Bruce Keogh, NHS England’s Medical Director, has undertaken a review of the National Clinical Director (NCD) resource designed to focus clinical advisory resources on areas where major programmes of work are currently being taking forward, or areas identified as priorities for improvement. As a result of the review, NHS England has proposed to change the way in which clinical advice is received in speciality areas in the future, streamlining and strengthening its clinical advisory mechanisms in support of the Five Year Forward View and the National Health Service’s key improvement priorities.Whilst there will no longer be a specific NCD role for neurology, NHS England will continue to secure expert clinical advice from its Clinical Networks and through its relationships with professional bodies and by appointing clinical advisors. Access to advice will be through clinical leads and members of the NHS England-funded neurology clinical networks, the Neurology Clinical Reference Group and Royal Colleges. It is expected that these new arrangements will be in place shortly.During 2016/17, the focus of NHS England’s improvement efforts delivered through Strategic Clinical Networks will be on a smaller range of key national priorities, including cancer, mental health, diabetes, maternity and urgent and emergency care (with a focus on cardiovascular disease transformation). Whilst there is no additional funding nationally, clinical and local networks of care can determine what can be done at a local or regional level if it is considered a local or regional system priority. Nationally, the policy team is considering how key aspects of the work on neurology can be taken forward through alternative mechanisms and partners.In addition, the Neurology Intelligence Network (NIN) is a joint partnership programme between Public Health England (PHE) and NHS England to support the generation and dissemination of neurology related health intelligence. PHE currently funds the on-going design, development and management of the NIN.

*No heading*

Lord Scriven: To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 23 March (HL6926), whether the issue of the sugar tax to be introduced by NHS England in their own premises by 2020 was raised as part of their conversations with NHS England, and if so, by whom and which ministers were consequently informed.

Lord Scriven: To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 23 March (HL6926), on what date the Department of Health was informed that NHS England was going to introduce a sugar tax in NHS premises by 2020.

Lord Prior of Brampton: We have a range of conversations about key issues at Ministerial and official level with NHS England. NHS England is independent and the decision on a sugar levy on the National Health Service estate is a matter for them operationally. We are interested to see the results of their consultation on a sugar levy. The announcement of a soft drinks industry levy by the Chancellor in the Budget is the first step in our comprehensive Childhood Obesity Strategy, which will be launched in the summer, and gives companies strong incentives to reformulate their products.

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Lord Mancroft: To ask Her Majesty’s Government how many hepatitis C patients NHS England is planning to treat in 2016–17.

Lord Prior of Brampton: NHS England is planning to treat 10,000 patients with chronic hepatitis C in 2016/2017.

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Lord Mancroft: To ask Her Majesty’s Government for what reason NHS England intends to treat only a specified number of patients in 2016–17, as defined by recently published run rates for operational delivery networks services.

Lord Prior of Brampton: The National Institute for Health and Care Excellence (NICE) specifically requires Operational Delivery Networks (ODNs) to prioritise hepatitis C patients on the basis of highest unmet clinical need, as part of a progressive rollout of treatments over the next five years. NHS England is funding providers to double the number of patients treated and this number will ensure the National Health Service fully meets in 2016/17 the patient numbers NICE set out for progressive rollout of the treatments at the time it published its guidance. NHS England has invested in a Commissioning for Quality and Innovation scheme to incentivise ODNs to meet their agreed rate of roll-out. If their treatment rates deviate from this agreed rate of treatment, they are no longer eligible for these incentives. In meeting the obligations of its Mandate, NHS England has set out a planning approach for hepatitis C that delivers access to NICE recommended treatment without disinvestment in other health services.

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Lord Mancroft: To ask Her Majesty’s Government how many people diagnosed with hepatitis C are eligible for treatment under the National Institute for Health and Care Excellence guidance for new direct acting antiviral drugs.

Lord Prior of Brampton: Based on National Institute for Health and Care Excellence (NICE) modelling, NHS England has planned for 10,000 patients to be treated in 2016/17. No national registry exists for hepatitis C and as a result NICE estimates that the NHS should be treating 10,000 people based on the total number of people diagnosed with hepatitis C, their genotype, their treatment history and their disease severity, all of which impact on treatment eligibility.

*No heading*

Lord Mancroft: To ask Her Majesty’s Government what plans they have to review their hepatitis C strategy in the light of other European countries' strategies for tackling hepatitis C.

Lord Mancroft: To ask Her Majesty’s Government whether plans to introduce a hepatitis C improvement framework have been abandoned and, if so, why.

Lord Mancroft: To ask Her Majesty’s Government what plans they have to ensure that the objectives of the hepatitis C improvement framework can still be achieved.

Lord Prior of Brampton: NHS England has been rapidly working on their plans for access to treatment during 2016/17 following enactment of the National Institute for Health and Care Excellence technical appraisal guidance and has committed to produce an operational framework for the treatment of hepatitis C during 2016/17. This will set out NHS England’s commitment to improving outcomes in hepatitis C across England.